Document Detail

Prior statin use is associated with improved outcomes in community-acquired pneumonia.
MedLine Citation:
PMID:  18954848     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Statins have potent anti-inflammatory effects in laboratory studies of pulmonary inflammation. We investigated whether statin users had improved outcome when admitted with community-acquired pneumonia. METHODS: We carried out a prospective observational study of patients admitted to the hospital with community-acquired pneumonia between January 2005 and November 2007. The use of statins, angiotensin-converting enzyme inhibitors, beta-blockers, and aspirin were recorded. The outcomes of interest were 30-day mortality, need for mechanical ventilation or inotropic support, and the development of complicated pneumonia. RESULTS: On multivariate logistic regression, statin use was associated with significantly lower 30-day mortality (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI], 0.25-0.85, P=.01) and development of complicated pneumonia (AOR 0.44, 95% CI, 0.25-0.79, P=.006). There was no effect on requirement of mechanical ventilation or inotropic support (AOR 0.93, 95% CI, 0.49-1.76, P=.8). Patients prescribed statins had more severe pneumonia (median Pneumonia Severity Index 4, interquartile range [IQR] 3-4) compared with patients not prescribed cardiovascular drugs (median Pneumonia Severity Index 3, IQR 2-4, P < .0001). Despite this, C-reactive protein levels on admission were significantly lower in patients prescribed statins (median 119 mg/L, IQR 46-215) compared with patients prescribed no cardiovascular drugs (182 mg/L, IQR 66-326, P < .0001). On multivariate logistic regression, statin use was independently protective against a C-reactive protein that failed to fall by 50% or more at day 4 (AOR 0.50, 95% CI 0.27-0.92, P=.02). CONCLUSIONS: Statin use is associated with reduced markers of systemic inflammation and improved outcomes in patients admitted with community-acquired pneumonia.
James D Chalmers; Aran Singanayagam; Maeve P Murray; Adam T Hill
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  121     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-28     Completed Date:  2008-11-25     Revised Date:  2009-04-20    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1002-1007.e1     Citation Subset:  AIM; IM    
Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
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MeSH Terms
Aged, 80 and over
C-Reactive Protein / metabolism*
Cardiovascular Diseases / drug therapy
Community-Acquired Infections / complications,  metabolism,  mortality
Confounding Factors (Epidemiology)
Empyema, Pleural / etiology
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Middle Aged
Pneumonia / complications,  metabolism,  mortality*
Prospective Studies
Respiration, Artificial
Scotland / epidemiology
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 9007-41-4/C-Reactive Protein
Comment In:
Am J Med. 2009 May;122(5):e15; author reply e17   [PMID:  19375535 ]

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